Amphetamines drug overdose

Rush, Roll, Higgins, 1998). The combination of cocaine (or amphetamine) and heroin (or other opiate) is called a speedbair and is particularly popular among heroin addicts. Morphine and cocaine combinations have been studied in the laboratory, and as with alcohol, morphine appeared to enhance the pleasurable effects of cocaine but also increased the cardiovascular effects. Combinations of cocaine and heroin have sometimes been blamed for drug overdose deaths (as in the deaths of comedian John Belushi and actor River Phoenix), and the synergistic effects on blood pressure and heart rate may be a factor (Foltin Fischman, 1992 Rush et al., 1998). 

Albertson TE, Van Hoozen BF, Allen RP. Amphetamines. In Haddad LM, Shannon MW, Winchester JF, eds. Clinical management of poisoning and drug overdose, 3 ed. Philadelphia WB Saunders Co, 1998 560-8. 

Drug overdoses involving stimulants (eg, amphetamines, cocaine, phencyclidine, monoamine oxidase inhibitors) or strychnine. 

The answer is c. (Hardman, pp 574—575.) Phencyclidine is a hallucinogenic compound with no opioid activity Its mechanism of action is amphetamine-like. A withdrawal syndrome has not been described for this drug in human subjects. In overdose, the treatment of choice for the psychotic activity is the antipsychotic drug haloperidol. 

Amphetamine (Benzedrine). Amphetamine was synthesized in 1887. It was quickly found to be a potent stimulant with effects similar to cocaine, which had been discovered over 100 years before. In the subsequent years, amphetamine found a variety of uses. It was used to treat narcolepsy, Parkinson s disease, barbiturate overdose, bed wetting (enuresis), and obesity. It was also used to counteract the sedating effects of other drugs and medications including antiseizure medications and alcohol. 

Previously popular but of unproved value, forced diuresis may cause volume overload and electrolyte abnormalities and is not recommended. Renal elimination of a few toxins can be enhanced by alteration of urinary pH. For example, urinary alkalinization is useful in cases of salicylate overdose. Acidification may increase the urine concentration of drugs such as phencyclidine and amphetamines but is not advised because it may worsen renal complications from rhabdomyolysis, which often accompanies the intoxication. 

Amphetamines are often combined with cocaine to extend the high. Cocaine creates a rush but it is short-lived. Adding amphetamines extends the high for up to ten hours. Using these drugs together increases the chances of an overdose and increases toxic effects. 

The report says that the most vulnerable group of users to ketamine overdose are those who take it under the illusion they are taking MDMA or some other stimulant drug. Someone expecting to take MDMA, cocaine, or amphetamine, for instance, may find themselves on a roadway behind the wheel of a car being affected instead by sudden physical incapacity. 

Cardiovascular toxicity is also frequently encountered in poisoning. Hypotension may be due to depression of cardiac contractility hypovolemia resulting from vomiting, diarrhea, or fluid sequestration peripheral vascular collapse due to blockade of -adrenoceptor-mediated vascular tone or cardiac arrhythmias. Hypothermia or hyperthermia due to exposure as well as the temperature-dysregulating effects of many drugs can also produce hypotension. Lethal arrhythmias such as ventricular tachycardia and fibrillation can occur with overdoses of many cardioactive drugs such as ephedrine, amphetamines, cocaine, tricyclic antidepressants, digitalis, and theophylline. 

Sometimes, we may want to use a f-test in a way that differs from our previous approach. Say, for example, we are considering the use of urinary acidification to hasten the clearance of amphetamine from patients who have overdosed. An initial trial in rabbits is used to test the general principal. One group of rabbits receives ammonium chloride to induce a lower urinary pH and another group acts as controls. All rabbits receive a test dose of radio-labelled drug, the clearance of which is studied over a few hours. In this case, the question posed should be is there an increase in clearance rather than the standard is there a difference in clearance The former constitutes a one-sided question. 

Many recreational drugs such as benzodiazepines, amphetamines, and opioids are also metabolized by the liver. Although information is scant about the clinical significance and interactions between these drugs and antiretroviral agents, unintentional overdoses with methamphetamine and gamma hydroxybutyrate have been reported in patients using Pis, particularly ritonavir. Pis and NRTIs may alter metabohsm of methadone and precipitate opioid withdrawal (McCance-Katz et al., 2003). 

So the paranoid psychosis produced by cocaine and amphetamine overdose is properh called stimulant psychosis. By the late 1960s, the word was out on the street— Speed kills What was referred to in this slogan was not just death by overdose. Amphetamine overdose deaths did occur, but they were relatively rare. Far more common was the development of a paranoid state that often led to acts of violence. In addition, after a long binge of amphetamine abuse, the user may crash (sleep for an extended period) and then awaken deeply depressed. The depression could last for days and is now recognized as a common withdrawal symptom after hca%7 use of either amphetamine or cocaine. The depression often leads the user back to drugs to try to get up again, and the cycle is repeated. Eventually the user s physical and mental health deteriorates badly unless he or she can break out of the cycle. 

Problems can also occur if a drug taken to inhibit a metabolic reaction is taken with a drug normally metabolized by that reaction. The latter would then be more slowly metabolized, increasing the risk of an overdose. For example, the antidepressant drug phenelzine (Fig. 8.4) inhibits the metabolism of amines and should not be taken with drugs such as amphetamines or pethidine. Even amine-rich foods can lead to adverse effects, implying that cheese and wine parties are hardly the way to cheer the victim of depression. 

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